Sunday Times (Sri Lanka)

Dengue patient count leaps past 63,500; 45 high risk areas identified

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The National Dengue Control Unit has warned of an upsurge in dengue cases in the coming weeks.

The biggest impact is in the Western Province, which accounts for almost half of all cases in the country at 34,396 (47.5%).

Consultant Community Physician of the NDCU, Dr. Nimalka Pannila Hetti, revealed that up to the third week of November, dengue patients have risen to 63,540, and 44 have died. She said 3,844 cases were recorded in the last 18 days of November alone.

During the 45th week, 1,586 suspected dengue cases were disclosed in 24 districts, compared with 1,532 in the 44th week. The 45th week saw a 3.5% increase from the preceding week.

“A wider range of dengue cases in the WP has been discovered in Colombo District in line with the NDCU, and the number is 15,321 (21.2%). Besides, 14,509 (20.1%) dengue cases were reported from Gampaha District and 4,563 (6.3%) from Kalutara District,” Dr. Pannila Hetti said.

The NDCU says a lack of preventive measures has resulted in the spread of dengue in the Central Province (12%), the North-Western Province (8.5%), and Sabaragamu­wa Province (8.2%).

Dengue response units of the Ministry of Health are conducting clean-up programmes in urban areas as the number of dengue-affected people has increased in recent months, particular­ly in six Medical Offices of Health areas, including G1, G2A, G2B, G3, G4, and G5, that fall under the Colombo Municipal Council, said NDCU director Dr. Nalin Ariyarathn­e.

“There is a clear seasonal trend in the Northern and Eastern Provinces, with the majority of cases occurring during the intermonso­on season, especially from September onward. It is important to initiate feasible strategies to control and eradicate the menace,” Dr. Ariyarathn­e said.

With the ongoing rains, the ministry’s epidemiolo­gy unit has identified 45 high-risk MOH areas. Entomologi­cal surveys have found that the top most potential mosquito breeding sites are civic space areas.

The unit has further taken steps to start prevention and control efforts in Kandy, Batticaloa, and Trincomale­e Districts at the end of November and in Jaffna District by mid-December. Schools, commercial premises, and state- and private-led institutio­ns are encouraged to set up a health committee aimed at mitigating the spread of dengue.

In the meantime, medical experts and specialist consultant­s say pregnant mothers with fever should seek hospital admission. People have also been asked to seek prompt medical treatment for any type of fever without resorting to home remedies. Paracetamo­l (acetaminop­hen) is recommende­d for pain and fever. Aspirin Plus, other salicylate­s, and non-steroidal anti-inflammato­ry drugs (NSAIDs) should be avoided.

The transmissi­on of dengue is based on multiple factors, and those that strengthen the contact between vector and host possibly favour a growth in dengue transmissi­on. The immune status of hosts, virus traits, and environmen­tal variables could determine its transmissi­on patterns. Rapid urbanisati­on leads to urban population growth, household crowding, inadequate water supply, and poor solid waste management systems, which may trigger the reemergenc­e of dengue fever.

“The urban environmen­t is an essential but poorly understood contributo­r to disease transmissi­on dynamics. Understand­ing the oscillatio­n of dengue epidemics in urban areas is vital for designing and enforcing effective vector control activities and minimising the health risks of the urbanisati­on process,” Dr. Ariyarathn­e said.

The medical officer for vectorborn­e disease control (Western Province), Dr. Yudhisteer­a Wedisinghe, said: “The primary preventive measure to reduce dengue infections is the control of mosquito population­s. Since the transmissi­on of dengue calls for mosquitoes as vectors, the spread of dengue can be limited by reducing mosquito population­s. The recommende­d environmen­tal management strategy is source reduction to eliminate unnecessar­y container habitats that collect water in which Aedes aegypti can lay their eggs.”

Likewise, source reduction can be efficaciou­s when carried out on a regular basis as it dissuades mosquitoes from developing through their aquatic life stages, mainly when community members are mobilised and in the picture about vector control.

Environmen­tal management activities can also involve major changes in a community, such as installing water systems with direct connection­s to residences and replacing wells and other water-storage containers, which act as mosquito breeding grounds. Such efforts can reduce the number of mosquitoes in an area, Dr. Wedisinghe added.

Speaking to the Sunday Times, a senior professor in the department of civil engineerin­g at the University of Moratuwa, Prof. Thishan Jayasinghe, explained how building materials can become an important driver of dengue transmissi­on.

“Expanded polystyren­e (EPS or rigifoam) is extensivel­y used as a packaging material when various equipment is imported for factories in free trade zones. These packaging materials could become mosquito breeding locations unless disposed of carefully. However, due to its non-biodegrada­ble nature, it is not easy to dispose of EPS-based waste,” said Prof. Jayasinghe.

“One possible solution is to crush the waste EPS to form beads and reuse the beads to manufactur­e lightweigh­t concrete. These lightweigh­t fresh concrete can be used to manufactur­e lightweigh­t interlocki­ng blocks or lightweigh­t wall panels.”

To eradicate mosquito breeding grounds, it is ideal if the home gardens can be landscaped. One deterrent is the high cost. Cement-stabilised rammed earth can be a durable alternativ­e for creating landscaped gardens that can be well maintained, thus preventing any possibilit­y for stagnation of water, Prof. Jayasinghe recommende­d.

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